Dementia Care Coordinator

Primary Healthcare Darlington

Information:

This job is now closed

Job summary

As a Dementia Care Co-ordinator, you will work as part of our PCN team supporting patients with dementia and their carers/families. The role involves building strong relationships with patients and their families/carers, ensuring they have access to relevant and appropriate services to meet their need. Working as part of a multi-disciplinary team, and with GP surgeries across Darlington, you will help to ensure that people with dementia receive high quality personalised care.

*Please note we will close this advert early if a large number of applications are received.

Main duties of the job

You will be a caring, dedicated, reliable and person-focused individual who enjoys working with a wide range of people. You will have good written and verbal communication skills and strong organisational and time management skills. As this is a new and evolving role, we are looking for highly motivated and proactive applicants with a flexible attitude, keen to work and learn as part of a team. There is a requirement to visit patients at home therefore the ability to drive and the use of a car is essential.

Key Objectives

· Co-produce a personalised support plan that ensures people with dementia have access to services that support them to live at home longer

· Promote people with dementia’s capabilities and personal resilience skills by ensuring they have the resources they need to live the life they want

· Improve people with dementia’s understanding of avoidable risks to their overall wellbeing, manage and reduce personal risk, increased ability to make positive choices to keep safe and well.

About us

Primary Healthcare Darlington was established in 2014 as the local GP federation consisting of 11 GP Practices covering an ever-increasing population of 108,000+ registered patients in Darlington, County Durham. We have close links with Darlington Borough Council and local NHS Foundation Trusts and have the full support and backing of Tees Valley CCG.

Working from newly refurbished dedicated premises close to Darlington Memorial Hospital we provide NHS, Public Health and Private Medical Services.

We are an award-winning company who places the wellbeing of our staff at the heart of everything we do. We have a wellbeing lead who offers staff access to multiple wellbeing resources, and as a company we offer staff access to free counselling services, protected time to develop professionally, access to high-quality training and development, weekly fresh fruit deliveries, free tea and coffee and chilled, filtered water and much more. We also offer staff an opportunity to volunteer for 4 days annually in the local community.

PHD is an Equal Opportunities employer and positively encourages applications from suitably qualified and eligible candidates, regardless of age, sex, race, disability, sexual orientation, gender reassignment, religion or belief, or pregnancy and maternity. We guarantee an interview to disabled candidates who meet the minimum criteria. We welcome requests for flexible working.

Date posted

26 April 2022

Pay scheme

Other

Salary

£11.64 an hour

Contract

Fixed term

Duration

12 months

Working pattern

Full-time, Flexible working

Reference number

U0016-22-5653

Job locations

Forsyth House

20 Woodland Road

Darlington

County Durham

DL3 7PL


Job description

Job responsibilities

Key Responsibilities

· Provides care coordination and navigation for people with dementia and their families across health and care services, working closely with social prescribing link workers, health and wellbeing coaches, and other primary care professionals such as First Contact Physiotherapists

· Assists people with dementia to access peer support or interventions that support them in their health and wellbeing and increase their activation level and explore and assist them to access personal health budgets where appropriate

· Promotes effective communication with people with dementia and their families, ensuring use of additional services where required, e.g., translation services, communication aids, visual aids

· Liaises with other agencies, providers, service users/carers during the planning implementation and evaluations of care as appropriate to the role

· Supports people with dementia and their families to utilise decision aids in preparation for appropriate shared decision-making conversation

· Brings together all of a person’s identified care and support needs, and explore options to meet these within a single personalised care and support plan (PCSP), in line with PCSP best practice, based on what matters to the person

· Helps people with dementia and their families to manage their needs through answering queries, making and managing appointments, and ensuring that people have good quality written or verbal information to help them make choices about their care

· Supports people with dementia and their families to access appropriate benefits where eligible

· Provides personalised support to people with dementia and their families to take control of their wellbeing, live independently and improve their health outcomes.

· Develops trusting relationships by giving people time to focus on ‘what matters to me’.

· Manages and prioritises own caseload in accordance with the needs, priorities and any urgent support required by individuals on the caseload.

· Has a strong awareness and understanding of when it is appropriate or necessary to refer people back to other health professionals/agencies, when what the person needs is beyond the scope of the link worker role, e.g., when there is a mental health need requiring a qualified practitioner.

Administrative Responsibilities

· Work with Practices to identify and manage a caseload of patients, and where required and as appropriate, refer people back to other health professionals within the PCN

· Raise awareness within the PCN of shared-decision making and decision support tools

· Raise awareness of how to identify patients who may benefit from shared decision making and support PCN staff and patients to be more prepared to have shared decision-making conversations

· To work as a key member of the MDT to help support the development of effective MDT meetings

· To ensure that action points identified within the MDT are recorded and followed up

· Ensure that patient Care Plans, diagnostics results and associated correspondence are available to the MDT, liaising with all agencies as appropriate, accessing IT systems to ensure relevant information is available

Data capture

· Work sensitively with people with dementia and their families to capture key information, enabling tracking of the impact of care co-ordination on their health and wellbeing.

· Encourage people with dementia and their families to provide feedback and to share their stories about the impact of care co-ordination on their lives.

· Work closely within the MDT and with GP practices within the PCN to ensure that care co-ordination referral codes are inputted into clinical systems (as outlined in the Network Contract DES), adhering to data protection legislation and data sharing agreements.

· Handle function specific information, which may be sensitive, complex, or confidential and appropriately recording, transferring and/or coordinating such information in accordance with the Data Protection Act; Caldicott Guidelines and the Confidentiality Code of Conduct Professional development.

· Work with the care co-ordination team leader to undertake continual personal and professional development, taking an active part in reviewing and developing the roles and responsibilities.

· Adhere to organisational policies and procedures, including confidentiality, safeguarding, lone working, information governance, equality, diversity and inclusion training and health and safety.

· Work with your supervising GP to access regular clinical supervision, to enable you to deal effectively with the difficult issues that people present.

Miscellaneous

· Work as part of the healthcare team to seek feedback, continually improve the service and contribute to business planning.

· Contribute to the development of policies and plans relating to equality, diversity, and health inequalities.

· Contribute to the achievement and maintenance of CQC registration status in PCN practices and Primary Healthcare Darlington (PHD).

· Undertake any tasks consistent with the level of the post and the scope of the role, ensuring that work is delivered in a timely and effective manner.

· As new priorities come along in the changing NHS, duties may vary from time to time, without changing the general character of the post or the level of responsibility.

· Communicate effectively and sensitively and use language appropriate to clients and families/carers.

· Effectively use a range of verbal and non-verbal methods of communication and be aware of and manage barriers to communication.

· Effectively recognise and manage challenging situations and deescalate appropriately.

· Participate in MDT learning activities.

· Completion of Statutory & Mandatory annual training.

Quality

· Contribute to the achievement of quality improvement initiatives.

· Inspire innovation amongst the team and stimulate improvement activities.

· Ensure compliance with CQC and professional standards.

· Promote a culture of constant improvement and excellence.

· Understand a risk management approach and apply it to all activities.

· Contribute with integrity to teamwork focused on improving quality within PHD.

· Contribute to the effectiveness of the team by reflecting on own and team activities and making suggestions on ways to improve and enhance the team’s performance.

· Contribute to regular audits and other improvement activities.

· Involvement in national and local quality improvement projects.

· Assess own performance and take accountability for own actions, either directly or under supervision.

· Take responsibility for own development, learning and performance and demonstrate skills and activities to others who are undertaking similar work.

Confidentiality

· In the course of seeking treatment, patients entrust us with, or allow us to gather, sensitive information in relation to their health and other matters. They do so in confidence and have the right to expect that staff will respect their privacy and act appropriately.

· In the performance of the duties outlined in this Job Description, the post-holder may have access to confidential information relating to patients and their carers’, practice staff and other healthcare workers. They may also have access to information relating to the PCN, its member practices and PHD as business organisations. All such information from any source is to be regarded as strictly confidential.

· Information relating to patients, carers, colleagues, other healthcare workers or the business of the PCN and its member practices may only be divulged to authorised persons in accordance with the practice policies and procedures relating to confidentiality and the protection of personal and sensitive data.

· The post holder has a responsibility to comply with the Data Protection Act 1998, NHS Confidentiality guidance (e.g., Caldicott) and any code of practice on Confidentiality and Data Protection as accepted by the PCN practices.

· All employees must adhere to PHD policies and procedures.

Health and Safety

· The post holder is required to take responsible care for the health and safety of themselves and other persons who may be affected by their omissions at work.

· The post holder is also required to cooperate with PHD to ensure that statutory and departmental regulations are adhered to.

Personal/Professional Development

The post-holder will participate in any training programme implemented by PHD as part of this employment, such training to include participation in an annual individual performance review, including taking responsibility for maintaining a record of own personal and/or professional development.

Job description

Job responsibilities

Key Responsibilities

· Provides care coordination and navigation for people with dementia and their families across health and care services, working closely with social prescribing link workers, health and wellbeing coaches, and other primary care professionals such as First Contact Physiotherapists

· Assists people with dementia to access peer support or interventions that support them in their health and wellbeing and increase their activation level and explore and assist them to access personal health budgets where appropriate

· Promotes effective communication with people with dementia and their families, ensuring use of additional services where required, e.g., translation services, communication aids, visual aids

· Liaises with other agencies, providers, service users/carers during the planning implementation and evaluations of care as appropriate to the role

· Supports people with dementia and their families to utilise decision aids in preparation for appropriate shared decision-making conversation

· Brings together all of a person’s identified care and support needs, and explore options to meet these within a single personalised care and support plan (PCSP), in line with PCSP best practice, based on what matters to the person

· Helps people with dementia and their families to manage their needs through answering queries, making and managing appointments, and ensuring that people have good quality written or verbal information to help them make choices about their care

· Supports people with dementia and their families to access appropriate benefits where eligible

· Provides personalised support to people with dementia and their families to take control of their wellbeing, live independently and improve their health outcomes.

· Develops trusting relationships by giving people time to focus on ‘what matters to me’.

· Manages and prioritises own caseload in accordance with the needs, priorities and any urgent support required by individuals on the caseload.

· Has a strong awareness and understanding of when it is appropriate or necessary to refer people back to other health professionals/agencies, when what the person needs is beyond the scope of the link worker role, e.g., when there is a mental health need requiring a qualified practitioner.

Administrative Responsibilities

· Work with Practices to identify and manage a caseload of patients, and where required and as appropriate, refer people back to other health professionals within the PCN

· Raise awareness within the PCN of shared-decision making and decision support tools

· Raise awareness of how to identify patients who may benefit from shared decision making and support PCN staff and patients to be more prepared to have shared decision-making conversations

· To work as a key member of the MDT to help support the development of effective MDT meetings

· To ensure that action points identified within the MDT are recorded and followed up

· Ensure that patient Care Plans, diagnostics results and associated correspondence are available to the MDT, liaising with all agencies as appropriate, accessing IT systems to ensure relevant information is available

Data capture

· Work sensitively with people with dementia and their families to capture key information, enabling tracking of the impact of care co-ordination on their health and wellbeing.

· Encourage people with dementia and their families to provide feedback and to share their stories about the impact of care co-ordination on their lives.

· Work closely within the MDT and with GP practices within the PCN to ensure that care co-ordination referral codes are inputted into clinical systems (as outlined in the Network Contract DES), adhering to data protection legislation and data sharing agreements.

· Handle function specific information, which may be sensitive, complex, or confidential and appropriately recording, transferring and/or coordinating such information in accordance with the Data Protection Act; Caldicott Guidelines and the Confidentiality Code of Conduct Professional development.

· Work with the care co-ordination team leader to undertake continual personal and professional development, taking an active part in reviewing and developing the roles and responsibilities.

· Adhere to organisational policies and procedures, including confidentiality, safeguarding, lone working, information governance, equality, diversity and inclusion training and health and safety.

· Work with your supervising GP to access regular clinical supervision, to enable you to deal effectively with the difficult issues that people present.

Miscellaneous

· Work as part of the healthcare team to seek feedback, continually improve the service and contribute to business planning.

· Contribute to the development of policies and plans relating to equality, diversity, and health inequalities.

· Contribute to the achievement and maintenance of CQC registration status in PCN practices and Primary Healthcare Darlington (PHD).

· Undertake any tasks consistent with the level of the post and the scope of the role, ensuring that work is delivered in a timely and effective manner.

· As new priorities come along in the changing NHS, duties may vary from time to time, without changing the general character of the post or the level of responsibility.

· Communicate effectively and sensitively and use language appropriate to clients and families/carers.

· Effectively use a range of verbal and non-verbal methods of communication and be aware of and manage barriers to communication.

· Effectively recognise and manage challenging situations and deescalate appropriately.

· Participate in MDT learning activities.

· Completion of Statutory & Mandatory annual training.

Quality

· Contribute to the achievement of quality improvement initiatives.

· Inspire innovation amongst the team and stimulate improvement activities.

· Ensure compliance with CQC and professional standards.

· Promote a culture of constant improvement and excellence.

· Understand a risk management approach and apply it to all activities.

· Contribute with integrity to teamwork focused on improving quality within PHD.

· Contribute to the effectiveness of the team by reflecting on own and team activities and making suggestions on ways to improve and enhance the team’s performance.

· Contribute to regular audits and other improvement activities.

· Involvement in national and local quality improvement projects.

· Assess own performance and take accountability for own actions, either directly or under supervision.

· Take responsibility for own development, learning and performance and demonstrate skills and activities to others who are undertaking similar work.

Confidentiality

· In the course of seeking treatment, patients entrust us with, or allow us to gather, sensitive information in relation to their health and other matters. They do so in confidence and have the right to expect that staff will respect their privacy and act appropriately.

· In the performance of the duties outlined in this Job Description, the post-holder may have access to confidential information relating to patients and their carers’, practice staff and other healthcare workers. They may also have access to information relating to the PCN, its member practices and PHD as business organisations. All such information from any source is to be regarded as strictly confidential.

· Information relating to patients, carers, colleagues, other healthcare workers or the business of the PCN and its member practices may only be divulged to authorised persons in accordance with the practice policies and procedures relating to confidentiality and the protection of personal and sensitive data.

· The post holder has a responsibility to comply with the Data Protection Act 1998, NHS Confidentiality guidance (e.g., Caldicott) and any code of practice on Confidentiality and Data Protection as accepted by the PCN practices.

· All employees must adhere to PHD policies and procedures.

Health and Safety

· The post holder is required to take responsible care for the health and safety of themselves and other persons who may be affected by their omissions at work.

· The post holder is also required to cooperate with PHD to ensure that statutory and departmental regulations are adhered to.

Personal/Professional Development

The post-holder will participate in any training programme implemented by PHD as part of this employment, such training to include participation in an annual individual performance review, including taking responsibility for maintaining a record of own personal and/or professional development.

Person Specification

Experience

Essential

  • Experience of administrative duties
  • Practical experience of being in a patient facing role
  • Working in a multi-disciplinary setting
  • Able to demonstrate a clear understanding of working with confidential information and an understanding of service user confidentiality
  • Experience in use of databases
  • Previous experience in NHS/Primary Care/Local Authority/VCSE sector role
  • Experience of working in a busy care environment

Desirable

  • Experience in promoting health and health improvement within the community, including health promotion campaigns and signposting to services
  • Knowledge/familiarity with medical terminology
  • Experience of supporting service improvement

Qualifications

Essential

  • Educated to GCSE Standard (Grades A-C) or Diploma/ HNC level (or relevant experience)
  • NVQ 2/3 or other qualification in health and social care

Desirable

  • ECDL or equivalent

Personal qualities, disposition and attributes

Essential

  • Able to deal with patients/clients sensitively, recognising cultural and psychological needs
  • Able to prioritise and manage own workload
  • Excellent interpersonal skills including ability to listen
  • Excellent organisational and administration skills
  • Professional attitude and assertive approach
  • Committed to personal development
  • Ability to meet deadlines and work under pressure
  • Approachable and flexible
  • Experience providing advice/signposting to patients/clients
  • Demonstrable ability to show kindness and compassion
  • Demonstrate ability to reflect and learn from situations
  • Identifies difficulties as challenges and works with others to identify solutions
  • Demonstrates co-operative team working and awareness of the roles of other professionals
  • Able to work on own initiative, organising and prioritising own workload to set deadlines
  • Ability to adapt and change approach as circumstance
  • Dictates
  • Persistence and ability to keep going in difficult situations and with complex and uncertain pieces of work
  • Understanding of and commitment to equality of opportunity and good working relationships
  • An ability to maintain confidentiality and trust
  • Can do attitude, able to maintain positivity in the face
  • of adversity
  • Good time keeping
  • Ability to work flexibly across days of the week
Person Specification

Experience

Essential

  • Experience of administrative duties
  • Practical experience of being in a patient facing role
  • Working in a multi-disciplinary setting
  • Able to demonstrate a clear understanding of working with confidential information and an understanding of service user confidentiality
  • Experience in use of databases
  • Previous experience in NHS/Primary Care/Local Authority/VCSE sector role
  • Experience of working in a busy care environment

Desirable

  • Experience in promoting health and health improvement within the community, including health promotion campaigns and signposting to services
  • Knowledge/familiarity with medical terminology
  • Experience of supporting service improvement

Qualifications

Essential

  • Educated to GCSE Standard (Grades A-C) or Diploma/ HNC level (or relevant experience)
  • NVQ 2/3 or other qualification in health and social care

Desirable

  • ECDL or equivalent

Personal qualities, disposition and attributes

Essential

  • Able to deal with patients/clients sensitively, recognising cultural and psychological needs
  • Able to prioritise and manage own workload
  • Excellent interpersonal skills including ability to listen
  • Excellent organisational and administration skills
  • Professional attitude and assertive approach
  • Committed to personal development
  • Ability to meet deadlines and work under pressure
  • Approachable and flexible
  • Experience providing advice/signposting to patients/clients
  • Demonstrable ability to show kindness and compassion
  • Demonstrate ability to reflect and learn from situations
  • Identifies difficulties as challenges and works with others to identify solutions
  • Demonstrates co-operative team working and awareness of the roles of other professionals
  • Able to work on own initiative, organising and prioritising own workload to set deadlines
  • Ability to adapt and change approach as circumstance
  • Dictates
  • Persistence and ability to keep going in difficult situations and with complex and uncertain pieces of work
  • Understanding of and commitment to equality of opportunity and good working relationships
  • An ability to maintain confidentiality and trust
  • Can do attitude, able to maintain positivity in the face
  • of adversity
  • Good time keeping
  • Ability to work flexibly across days of the week

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

Additional information

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

Employer details

Employer name

Primary Healthcare Darlington

Address

Forsyth House

20 Woodland Road

Darlington

County Durham

DL3 7PL


Employer's website

https://primaryhealthcaredarlington.co.uk/ (Opens in a new tab)

Employer details

Employer name

Primary Healthcare Darlington

Address

Forsyth House

20 Woodland Road

Darlington

County Durham

DL3 7PL


Employer's website

https://primaryhealthcaredarlington.co.uk/ (Opens in a new tab)

For questions about the job, contact:

Ethna Parker

ethna.parker@nhs.net

Date posted

26 April 2022

Pay scheme

Other

Salary

£11.64 an hour

Contract

Fixed term

Duration

12 months

Working pattern

Full-time, Flexible working

Reference number

U0016-22-5653

Job locations

Forsyth House

20 Woodland Road

Darlington

County Durham

DL3 7PL


Supporting documents